Medicare Subsidizing Prescription Drug Abuse

Medicare has been subsidizing prescription drug abuse by thousands of elderly and disabled people who are using the drugs to feed addictions or supply drug dealers who sell the drugs on the street for a profit. According to Congressional investigators, roughly 170,000 Medicare patients received prescriptions from 5 or more health care providers. These prescriptions included the top 14 drugs that are frequently abused. The investigators accuse Medicare officials of being slow to recognize the problem and take action to stop the misuse of federal Medicare funds.

The prescription drugs that Medicare patients most often abuse include powerful painkillers like OxyContin and Vicodin. These two drugs were involved in 8 out of 10 cases where patients visited multiple doctors for prescriptions (commonly referred to as “doctor shopping”). One case covered in the Congressional report involved a woman in Georgia who received a 150-day supply of OxyContin in 27 days by visiting 4 different doctors. In a single year, she saw 58 doctors and received prescriptions for over 3600 OxyContin pills (more than a 4-year supply), which she filled at 40 different pharmacies. Several similar cases involving other Medicare beneficiaries were included in the report.

Courtesy of Medicare

Auditors from the Government Accountability office found that prescription drug abuse is threatening the health of Medicare patients and increasing the health care burden of taxpayers. In many of the cases that were investigated, doctors had no idea that their Medicare patients were also seeing other doctors and obtaining duplicate prescriptions from them.
The auditors suggested that patients who have a history of abusing prescription drugs be limited to seeing one doctor and filling prescriptions at one pharmacy. According to the New York Times, Medicare officials responded by saying that they would rather not make program changes that would limit patients’ access to health care. Instead, Medicare deputy administrator Jonathan Blum suggested that increased monitoring of electronic health records should be used as weapon against prescription drug abuse. He also called on the private insurance companies that manage Medicare prescription drugs under government contract to identify patterns of prescription fraud.
Senator Tom Carper of Delaware, who requested the investigation, believes that Medicare has a responsibility to not worsen the prescription drug abuse problem in America. “We have a moral imperative to make sure the public health system is not used to subsidize and intensify a public health crisis.”
For now, prescription drug abuse continues to be the dark underside of Medicare’s prescription drug program. Not counting charges for office visits, the proliferation of fraudulent prescriptions is estimated to cost taxpayers an estimated $148 million per year.

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